成都市基层医疗机构基本药物制度初步实施效果调查

陈麒骏; 胡明; 骆康; 陈晓源

引用本文：陈麒骏,胡明,骆康,等.成都市基层医疗机构基本药物制度初步实施效果调查[J].中国卫生政策研究,2011,4(9):41-45

成都市基层医疗机构基本药物制度初步实施效果调查

投稿时间：2011-03-29 修订日期：2011-08-20 PDF全文浏览 HTML全文浏览

四川大学华西药学院

摘要:目的：评价成都市基层医疗机构基本药物可获得性及国家基本药物制度初步实施状况。方法：抽取成都市13家试点社区卫生服务中心和5家试点乡镇卫生院作为样本，采集其财务数据、药品清单，并分别抽取2009和2010年处方进行分析。结果：截至2010年5月，所调查的社区卫生服务机构和乡镇卫生院基本药物配备率分别为94.2%和62.2%；与2009年5月相比，次均处方基本药物种数比例同比增幅分别达9.6%和31.0%，次均处方基本药物费用比例同比增幅分别达57.6%和118%；而次均处方药品种数、含抗生素处方比例、含注射剂处方比例三项指标的年度变化都不明显。结论：财政补偿责任下沉，补偿存在机构间地区间差别；目录品种不能满足基层用药需求，目录遴选未与基本医疗服务挂钩；基本药物使用率提高，但对合理用药影响不明显，基本药物使用缺少激励。

关键词:基本药物制度基层医疗机构可获得性效果

基金项目:四川省卫生厅科研项目（100360）

Survey on the effect of primary medical institutions and evaluation of the implementation of national essential medicines system in Chengdu

Abstract:Objective：To evaluate the availability of national essential medicines and the preliminary implementation of national essential medicines system (NEMS) in the primary medical institutions in Chengdu. Methods：Survey was conducted on 13 pilot community health centers (CHC) and 5 pilot township health centers (THC), and prescriptions in May 2009 and 2010 in each institution were collected respectively to analyse the basic situation,availability of essential medicines, rational drug use. Results：Up to May of 2010, the deployment rate of essential medicines of CHC and THC were 94.2% and 62.2% respectively; compared with May of 2009, the increase rate of number of essential medicines out of total medicines on average per prescription were 9.6% and 31.0% respectively; the increase rate of cost of essential medicines out of total cost on average per prescription were 57.6% and 118% respectively; but there were no significant change in the number of prescriptions with injections, the number of prescriptions with injections, and the number of prescriptions with hormones out of total prescription. Conclusions：The responsibility of financial compensation went to a relative lowers administrative authority. the compensation are different among institutions and districts. The selecting standard of NEM list was not clear and could not meet the needs of primary medical service. The increased of essential medicines use could reduce the financial burden of medication， but exert subtle influence on rational drug use and there was no incentive for medical staff to prescribe essential medicines.

Key words:Essential medicines system Primary medical institutions Availability Effect

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